A urostomy is a

surgical procedure Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...

that creates a stoma (artificial opening) for the urinary system. A urostomy is made to avail for

urinary diversion Urinary diversion is a surgical technique used to create a new pathway for urine to exit the body, often following the removal of the bladder as part of treatment for bladder cancer. In addition to bladder cancer, urinary diversion may be necessa ...

in cases where drainage of urine through the bladder and urethra is not possible, e.g. after extensive surgery or in case of obstruction.Urostomy
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(American Cancer Society).Last Medical Review: 03/17/2011. Last Revised: 03/17/2011

Techniques

Techniques include: :::::::*

Ileal conduit urinary diversion An ileal conduit urinary diversion is one of various surgical techniques for urinary diversion. It has sometimes been referred to as the Bricker ileal conduit after its inventor, Eugene M. Bricker. It is a form of incontinent urostomy, and was d ...

, in which the

ureter The ureters are tubes composed of smooth muscle that transport urine from the kidneys to the urinary bladder. In an adult human, the ureters typically measure 20 to 30 centimeters in length and about 3 to 4 millimeters in diameter. They are lin ...

s are surgically resected from the bladder and a

ureteroenteric anastomosis Urinary diversion is a surgical technique used to create a new pathway for urine to exit the body, often following the removal of the bladder as part of treatment for bladder cancer. In addition to bladder cancer, urinary diversion may be necessa ...

is made in order to drain the urine into a detached section of

ileum The ileum () is the final section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms posterior intestine or distal intestine may ...

(a part of the

small intestine The small intestine or small bowel is an organ (anatomy), organ in the human gastrointestinal tract, gastrointestinal tract where most of the #Absorption, absorption of nutrients from food takes place. It lies between the stomach and large intes ...

). The end of the ileum is then brought out through an opening (a

stoma In botany, a stoma (: stomata, from Greek language, Greek ''στόμα'', "mouth"), also called a stomate (: stomates), is a pore found in the Epidermis (botany), epidermis of leaves, stems, and other organs, that controls the rate of gas exc ...

) in the

abdominal wall In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls. There is a common set of layers covering and forming all the walls: the deepest being the vi ...

. The urine is collected through a bag that attaches on the outside of the body over the stoma. :::::::*

Indiana pouch An Indiana pouch is a surgically-created urinary diversion used to create a way for the body to store and eliminate urine for patients who have had their urinary bladders removed as a result of bladder cancer, pelvic exenteration, bladder exstrop ...

A "continent urostomy" is an artificial bladder formed out of a segment of small bowel. This is fashioned into a pouch, which can be emptied intermittently with a catheter. It avoids the need for a stoma bag on the urostomy.

Routine care

The appliances are usually changed at a time of low fluid intake, such as early in the morning, where less urine production makes changing easier.Taylor, C. R., Lillis, C., LeMone, P., Lynn, P. (2011) Fundamentals of nursing: The art and science of nursing care. Philadelphia: Lippincott Williams & Wilkins, page 1254-1255.

Indications

Urostomy is most commonly performed after

cystectomy Cystectomy is a medical term for surgical removal of all or part of the urinary bladder. It may also be rarely used to refer to the removal of a cyst. The most common condition warranting removal of the urinary bladder is bladder cancer. Two mai ...

, such as may be necessary in, for example,

bladder cancer Bladder cancer is the abnormal growth of cells in the bladder. These cells can grow to form a tumor, which eventually spreads, damaging the bladder and other organs. Most people with bladder cancer are diagnosed after noticing blood in thei ...

. Other indications include severe kidney disease, accidental damage or injury to the urinary tract, surgical complications because of non-related pelvic or abdominal surgery, congenital defects that cause urine to back up into the kidneys, or

urinary incontinence Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a significant effect on quality of life. Urinary incontinence is common in older women ...

References

Pediatric surgical procedures Urologic surgery {{surgery-stub

Techniques

Routine care

Indications

See also

References